ASD Closure Surgery

The upper chambers of the heart are divided a wall called “interatrial septum”. The defect in this wall is known as Atrial septal defect (ASD). It is a form of a congenital heart defect, the defect the baby is born with. The reasons for developing of such a defect is not completely known, however it is believed that such defects could be due to genetic issues, issues with maternal health and risk factors. There are many types of atrial septal defects. They are differentiated from each other by whether they involve other structures of the heart and how they are formed during the developmental process during early fetal development. The Atrial septal defects include either the absence of this wall or defect in the wall. This leads to mixing of the blood in the upper chambers of the heart. Such a phenomenon of mixing of oxygen-deficient and oxygen-rich blood leads to lower-than-normal oxygen levels in the arterial blood that supplies the brain, organs, and tissues. Usually there are no initial symptoms or signs if the defect is small. Usually the very minute defects get automatically corrected as the baby develops. The defect of more than >9mm is usually clinical remarkable and results in overload on the either of the upper chambers depending on the flow of the blood (this is called as shunt). There are left-to-right shunt and right-to left shunts based on the flow direction of the blood leading to mixing under pressure. These shunts lead to overload on the lower chambers of the heart causing variety of heart ailments such as heart failure and pulmonary hypertension respectively. If left untreated, heart failure can completely lead to functioning of the heart and pulmonary hypertension can lead to cyanosis due to lack of oxygen. Both this conditions are life-threatening and could be fatal and needs immediate medical attention.

Depending on the size of the defect and the weight of the child, a physician may recommend an ASD closure for this condition. Catheter-based (a long, thin, flexible, hollow tube) procedures are used for diagnosis of the defect and also sealing this defect. There are special catheters called as an ASD device guided under radio-imaging technique (angiography which helps to visualise the heart chambers) to the heart wall and contains a disc which closes the hole in the heart wall. To help the exact location and measurement of the size of the heart, the defect and its complete sealing or replacement is assisted by ultra-sonography techniques and intra cardiac echo for functioning of the heart and blood flow. The device remains in the heart permanently to stop the abnormal flow of blood between the two atria chambers of the heart. The catheter is then removed once the procedure is completed.

Steps Involved:

Depending on the size of the defect and the weight of the child, a physician may recommend an ASD closure for this condition. Catheter-based (a long, thin, flexible, hollow tube) procedures are used for diagnosis of the defect and also sealing this defect. There are special catheters called as an ASD device guided under radio-imaging technique (angiography which helps to visualise the heart chambers) to the heart wall and contains a disc which closes the hole in the heart wall. To help the exact location and measurement of the size of the heart, the defect and its complete sealing or replacement is assisted by ultra-sonography techniques and intra cardiac echo for functioning of the heart and blood flow. The device remains in the heart permanently to stop the abnormal flow of blood between the two atria chambers of the heart. The catheter is then removed once the procedure is completed.

Advantage:

ASD closures offer a new lease of life to the new borne babies and they can lead a very healthy life. The ASD colures are permanent and once operated, usually the problems do not recur. They are safe and post-recovery period are quick and usually uneventful.

Precautions:

The ASD closure surgeries are necessary required in young children and thus they must have all other parameters normal for a successful procedure. The parents must undertake all the possible precautions to prevent infections such as flu, pneumonia etc. in the children which can put the body physiology under stress and reduced the immunity. When all parameters are stable, the procedure can be performed.

FAQs

What are the symptoms of ASD in children?

Most prominent symptoms of early childhood include Difficulty breathing (dyspnoea), Frequent respiratory infections in children, Sensation of feeling the heart beat (palpitations) in adults and Shortness of breath with activity

Do ASDs close spontaneously?

Small ASDs detected on echo immediately after birth or during infancy may close spontaneously, but most of the ASDs that are moderate or large sized do not close on their own.

What is the ideal age for ASD closure?

ASDs can be closed at any age, but if the child is asymptomatic, the defect can be electively closed at around 3 years.

Can the ASD be performed in adulthood?

Yes; they can be performed in adulthood and all the other concomitant diseases must be well managed and under control.

What are the usual side effect following ASD closure?

Generally mild fever, pain, headache are experienced by the patients immediately following the procedure. Medications to alleviate the conditions are helpful.

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